Should I insist my doctor order an MRI?

There are lots of magazine articles telling patients that if they want better care to speak up for themselves!  This brings up . . . are MRIs done too often? 

Magnetic Resonance Imaging has become a routine test in the evaluation of musculoskeletal conditions.   Most patients with neck, back, knee or shoulder pain will improve with conservative management.  MRI often shows pathology (aka that something is wrong)  that may have no relationship to the patient’s symptoms.  Tests have shown that young and middle-aged people with NO symptoms 30-40% of the time have changes in their disks.    The MRI can give confusing information that may not identify the source of pain. 

To optimize healing, I do a thorough history and physical exam.  Certainly, if there are “red alarms” like infection or acute disc herniation or cauda equina syndrome, then an MRI is warranted.   If conservative therapy does not help resolve the problem in 4 to 6 weeks, then an MRI may help also.  We physicians are trained to not obtain tests that won’t help the diagnosis or plan of care.  MRI is not indicated if the result will not alter treatment.  Muscle stretching and strengthening are the cornerstones of rehabilitation.  That requires the patient be motivated and engaged in therapy. 

cervical spine MRI

Hope this helps.

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About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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